神经外科患者术后感染病原菌分布及药敏性分析  

Distribution and drug susceptibility of pathogens causing postoperative infections in neurosurgery department patients

作　　者：崔植野 叶碎林[1] 金一勤[1] 成力伟[1] 张学磊[1] 王伟明[1] 

机构地区：[1]丽水市人民医院神经外科,浙江丽水323000

出　　处：《中华医院感染学杂志》2013年第22期5605-5606,共2页Chinese Journal of Nosocomiology

基　　金：浙江省药学会医院药学科研专项基金项目(2010ZYY25)

摘　　要：目的分析神经外科患者术后感染的病原菌分布及药敏性,为临床合理使用抗菌药物提供依据。方法回顾性分析2008-2011年76例神经外科术后感染患者的临床资料,采集感染部位痰液、脑脊液、脓液、血液等标本进行病原菌培养,对分离出的主要病原菌进行药敏试验。结果 76例术后感染患者的感染部位以下呼吸道感染为主占52.6%,其他依次为颅内、泌尿道、上呼吸道、胃肠道及血流感染,分别占27.6%、5.3%、3.9%、3.9%及2.6%;共分离出病原菌81株,其中铜绿假单胞菌为首占30.9%,其次为金黄色葡萄球菌、热带假丝酵母菌、肺炎克雷伯菌、阴沟肠杆菌、大肠埃希菌,分别占12.3%、11.1%、9.9%、6.2%、6.2%;铜绿假单胞菌对阿米卡星的敏感率最高为80.0%,对头孢三代抗菌药物耐药率达100.0%。结论神经外科术后发生医院感染的患者以下呼吸道为主,病原菌感染以铜绿假单胞菌为主,对于铜绿假单胞菌感染的患者可给予阿米卡星抗感染治疗。OBJECTIVE To analyze the distribution and drug susceptibility of pathogens causing postoperative infections in the neurosurgery department patients so as to guide the reasonable clinical use of antibiotics. METHODS The clinical data of 76 cases of patients with postoperative infections who were treated in the neurosurgery department from 2008 to 2011 were retrospectively analyzed, then the sputum, cerebra}, spinal fluid, pus, and. htood were sampled from the infection sites so as to perform the culture of pathogens, and the drug susceptibility testing was carried out for the main isolated pathogens. RESULTS There were totally 76 cases of postoperative infections, among which 52.6 % had the lower respiratory tract infections, 27.6 % the intracranial infections, 5. 3% the urinary tract infections, 3. 9% the upper respiratory tract infections, 3. 9% the gastrointestinal tract infections, 2.6% the bloodstream infections. A total of 81 strains of pathogens have been isolated, among which the Pseudomonas aeruginosa accounted for 30.9%, the Staphylococcus aureus 12. 3%/%, Candida tropicalis 11.1% , Klebsiella pneumoniae 9.9%, Enterobacter cloacae 6.2%, Escherichia coli 6.2%. The drug susceptibility rate of the P. aeruginosa to amikacin was the highest （80.0 %）, and the drug resistance rate to third generation cephalosporins reached as high as 100. 0 %. CONCLUSION The lower respiratory tract is the most common infection site of the neurosurgery department patients, the P. aeruginosa is the predominant species of pathogen causing the infections; amikaein can be used for the treatment of P. aeruginosa infections.

关 键 词：神经外科 术后感染 病原菌 分布 药敏性 

分 类 号：R378[医药卫生—病原生物学]